The proposed study is a randomized clinical trial of kidney transplant recipients to determine the effects of a one year program of exercise training on physical fitness and quality of life/well-being. Although kidney transplantation is a well accepted procedure, several studies report that a significant number of patients are limited in their ability to perform activities of daily living. Typically patients are followed medically for the functioning of their organ, however little attention and no interventions are incorporated to improve physical functioning. Preliminary studies in small numbers of patients suggest that transplant recipients can benefit from regular exercise training, however no randomized clinical study has been done to study the impact of such programs in a large number of patients. We propose to randomize 170 patients into 2 groups: usual care group and exercise intervention group. The exercise intervention will be initiated within 1 week after transplant and continue for 12 months. The exercise will be individually prescribed for daily independent walking or cycling at home. Aggressive adherence monitoring will be done by exercise logs, phone follow-up and regular physiologic monitoring during regularly scheduled clinic visits. Comparisons between groups will be made at baseline and at 3, 6, and 12 months in physical fitness and quality of life/well being. Measures of physical fitness will include: a) cardiorespiratory fitness as measured by maximal oxygen uptake, b) skeletal muscle strength as measured by isokinetic muscle testing and c) body composition as measured by dual x- ray absorptiometry. Quality of life/well-being will be measured using a well validated questionnaire. Additionally, clinical measures of transplant function, cardiovascular risk and dietary intake will be monitored to assess the impact of the intervention. Health care costs of both groups will also be evaluated. Data analysis techniques will test the effectiveness of the exercise intervention as well determine the relationship of several measured variables to quality of life/well being. This study is needed to demonstrate the impact of exercise training on optimizing functioning and quality of life over and above any improvements that may result from transplantation alone.